The ins and outs of living in Puerto Rico

Prenatal Care in Puerto Rico versus the US

I have had the opportunity to deliver a child in the US as well as in Puerto Rico, so this post is about the similarities and differences I found between prenatal care in Puerto Rico versus the US. First of all, it was WAY cheaper to have a baby in Puerto Rico than in the US. We paid a bit more out of pocket ($600) to our obstetrician for her fees for the extra ultrasounds, but overall the co-pays and such were much lower. Also, in Puerto Rico the epidural is covered by the insurance so that was a savings of $1600! Likewise, our insurance covered all of the hospital fees. The only out of pocket payment we made was for the private room we requested. Insurance did not cover that and it ended up costing us $200 per night, which was money well spent in my humble opinion! 😉 Besides cost, another difference we found was the amount of time spent at each prenatal appointment. At least with MY obstetrician, I received an ultrasound at EVERY appointment! This means that in Puerto Rico you have the opportunity to see your baby approximately 14 times if you go full term! Which I personally found to be very nice but time consuming. I didn’t mind though, because I found it incredibly reassuring to see my baby growing steadily at each appointment. In the US I only received 3 routine ultrasounds and one extra one when I had complications at 9 weeks. That meant that we only got to peek at the baby’s gender 1 time in the states! 🙁 In Puerto Rico we checked at every appointment after 16 weeks! Mostly because I wanted them to be VERY certain so that I could be sure to have my husband paint the nursery the right color. 😉 Another time consumer was the waiting time for each visit. We found that in the states if your appointment is at 3 pm, then you’ll likely be seen by 3:30 pm the latest, barring that you show up on time. In Puerto Rico, it doesn’t really matter what time your appointment is set for, once you arrive at the doctor’s office, you write your name at the bottom of the list of patients waiting to be seen, and then you sit down and you wait your turn. The doctors in Puerto Rico are not like in the states, they do not try to see a patient every 15 minutes. They are very thorough and they take their time to answer any questions you may have and will likely even talk to you for a few minutes about how your family is doing. Because of this, you can expect on most occasions to be sitting for awhile if you are at the bottom of a long list. So it’s always best to plan ahead and bring a book and not have any other appointments or places to be soon after your appointment, just in case your wait time stretches out over 2 hours. No doubt waiting can suck, but it’s not all bad because once YOU are the one sitting with the doctor getting all your questions answered, you know that you are not going to feel like they are rushing you out the door. I always felt like the doctors in the states were staring at the clock whenever I was struggling to remember what I wanted to ask. I never had that worry with my obstetrician in Puerto Rico, so that was nice. Aside from that, the prenatal appointments are spaced out the same:

Weeks 4 to 28: 1 prenatal visit a month

Weeks 28 to 36: 1 prenatal visit every 2 weeks

Weeks 36 to 40: 1 prenatal visit every week

Unless you have complications that require additional visits. One key difference in Puerto Rico versus the states when it came time to deliver was the fact that the hospital did not supply any towels or bedding for you. When you are admitted into the maternity ward they expect you to have your own:

Pillow (with cover)

Blankets

Bath towels

Personal care items- pads, soaps, etc

Bedpan

Water pitcher and cups

Pajamas

Socks

Disposable Camera

They actually have you purchase a kit that includes the bedpan and water pitcher from the pharmacy before being admitted and of course you get to take it home with you after! lol The disposable camera was a probably the most frustrating difference I found between having a baby in Puerto Rico versus in the US. With my first child we were able to have our cell phones and digital camera in the delivery room so we were able to make a short video of those first sweet cries as our new baby was being weighed and measured. In Puerto Rico (at least at the hospital were I delivered), no cameras capable of taking video were allowed. ONLY disposable cameras! 🙁 Not only did we not get any videos of our baby’s first cries, but we also had to take the disposable camera to Walgreens to have the pictures developed! Of course knowing this, my husband kept the pictures HE took as PG as possible, but at one point a nurse ended up taking pictures for us as my husband cut the cord, and lets just say the Walgreens photo technician got to see a bit more than I think they bargained for! Of course we had NO CLUE that those pictures were on the camera until after they were developed because you can’t go back and review your images on a disposable camera like you can with your digital one! Needless to say, we haven’t returned to have pictures developed at that particular Walgreens since! :-[ Other than that, the experience was pretty typical. After you deliver they leave you to breast feed for about an hour and then the nurse comes to take the baby and your husband to go weigh, measure, and bath the baby while you go into the recovery area. After you are finally able to get up and walk they move you to your room and help you to use the restroom, and then once you are ready they give you the go ahead to shower. Of course it was at this time that I realized that I had forgotten a bath towel and was overcome by hormones and emotions. Thankfully the nurse came running with a bed sheet for me to dry myself with and the crisis was resolved. So it is very important that you pack everything well in advance so you do not forget anything as to avoid any potential catastrophes or meltdowns such as the one I had. Once you are settled in your room- shared or private- you are allowed to have your baby with you as long as you are awake and able to attend to it. If you want to rest or use the rest room they request that you press the call light and ask that the baby be taken to the nursery if you do not have a visitor in your room during that time, just like in the states. At the hospital where I delivered in Puerto Rico the visiting hours where similar to those in the states for the shared room and extended to later in the evening for the private suite. However, regardless of which type of room you are staying in, your husband cannot stay the night in the room with you. In the states my husband stayed with me in the hospital every night that I was admitted, they even gave him his own bed to sleep in next to me. In Puerto Rico the men get the boot when visiting hours are over, even if he’s your father, brother, cousin, uncle, husband, etc. It does not matter, they have to leave. Only female visitors are allowed to stay over night with you. Of course no post about the similarities and differences between having a baby in Puerto Rico versus the US would be complete if I didn’t touch on the language differences. It is well known that the main language spoken in Puerto Rico is Spanish. Knowing some Spanish is extremely helpful but by no means required. I knew very little Spanish when I had my baby and it was not hard to find an obstetrician who spoken English. There were times when the nurses were not bilingual but it has been my experience that as long as you keep an open mind and be your own advocate if you feel that you are missing or not understanding something, and ask that a translator be provided, you will be just fine. Thankfully I had my husband as my translator 90% of the time, but even when he wasn’t present, the doctors and nurses were very helpful and patient when communicating with me. However, I cannot stress this point enough: You HAVE to be your own advocate if you need assistance with Spanish. Starring blankly at the nurse while she rattles off instructions to you is not helpful for anyone. Do not be ashamed to admit that you do not understand and need help. They will help make sure that you get the information you need IF you ask for it. Don’t let things get lost in translation, make sure that you understand and that everyone is understanding you so that you can be sure that you and your baby are getting the best care possible.

2 Comments

Hello Leah, if you are in the San Juan area, I would recommend a doctor that delivers wither at the Ashford Presbyterian Hospital in Condado or Auxilio Mutuo Hospital. The Presbyterian has more English-Speakers though. If you need an OB there is a group right there with the hospital that you can contact.